Neighborhoods influence children's health, so it is important to have measures of children's neighborhood environments. Using the Child Opportunity Index 2.0, a composite metric of the neighborhood conditions that children experience today across the US, we present new evidence of vast geographic and racial/ethnic inequities in neighborhood conditions in the 100 largest metropolitan areas in the US. Child Opportunity Scores range from 20 in Fresno, California, to 83 in Madison, Wisconsin. However, more than 90 percent of the variation in neighborhood opportunity happens within metropolitan areas. In 35 percent of these areas the Child Opportunity Gap (the difference between Child Opportunity Scores in very low-and very high-opportunity neighborhoods) is higher than across the entire national neighborhood distribution. Nationally, the Child Opportunity Score for White children (73) is much higher than for Black (24) and Hispanic (33) children. To improve children's health and well-being, the health sector must move beyond a focus on treating disease or modifying individual behavior to a broader focus on neighborhood conditions. This will require the health sector to both implement place-based interventions and collaborate with other sectors such as housing to execute mobility-based interventions.A long tradition of social science research has examined how neighborhoods influence socioeconomic and health outcomes during the life course. 1 In the past decade increasingly strong evidence indicates that there has been a causal relationship between children's neighborhood environment and educational attainment, employment, income, and health outcomes. 2,3 In addition, a large body of research has documented high levels of racial residential segregation in US metropolitan areas and high levels of geographic concentration of both poverty and affluence. [4][5][6][7] Starting in the 1990s, groundbreaking work by George Galster and colleagues has connected these two research traditions, ar-guing that an unequal "geography of opportunity" in metropolitan areas-that is, differential access to neighborhood-based opportunityleads to inequities in outcomes by race and ethnicity. 8,9 Building on the geography of opportunity scholarship, [10][11][12][13] in 2014 we published the Child Opportunity Index to provide the child health field with a measure of children's neighborhood opportunity, which we defined as the context of neighborhood-based conditions and resources (for example, early childhood education, schools, availability of healthy food) that influence children's healthy development and long-term outcomes such as health and socioeconomic mobility. 14 Our goal was to facilitate analysis of the

Using a capability approach, this study assesses economic constraints under the current US national unpaid family and medical leave (FML) policy compared to a hypothetical national paid FML policy for all full-year workers. Existing literature documents gender and class differences in barriers to FML use, but there is limited research on racial/ethnic minority workers. Our results indicate that if FML policy changed from unpaid to paid leave, black workers would gain a greater percentage of family income back relative to white workers, due in part to their larger wage contributions to family income. However, moving to a paid FML policy has a lower likelihood of preventing short-term economic hardship for black and Hispanic workers, compared to white workers. Our findings are consistent with studies, of which there are few, that show that paid FML can decrease, but not eliminate, disparities in black and Hispanic working mothers' capability to take up parental leave and use leave for longer durations. Therefore, further design modifications to FML policy are needed for paid leave to be fully protective of all workers who need to take leave without facing economic hardship. RESUMEN

Background In the U.S., sudden unexpected infant deaths (SUID) due to accidental suffocation and strangulation in bed (ASSB) are increasing, with disparities by race/ethnicity. While breastfeeding is a protective factor against infant mortality, racial/ethnic disparities are present in its uptake, and motivations to breastfeed are also often coupled with non-recommended infant sleep practices that are associated with infant sleep deaths. Combining infant safe sleep (ISS) and breastfeeding promotion on the community level presents opportunities to address racial/ethnic disparities and associated socioeconomic, cultural, and psychosocial influences. Methods We completed a descriptive qualitative hermeneutical phenomenology using thematic analysis of focus group data. We examined the phenomenon of community-level providers promoting ISS and breastfeeding in communities vulnerable to ISS and breastfeeding disparities. We asked eighteen informants participating in a national quality improvement collaborative about i.) areas requiring additional support to meet community needs around ISS and breastfeeding, and ii.) recommendations on tools to improve their work promoting ISS and breastfeeding. Results We identified four themes: i.) education and dissemination, ii.) relationship building and social support, iii.) working with clients’ personal circumstances and considerations, and iv.) tools and systems. Conclusions Our findings support embedding risk-mitigation approaches in ISS education; relationship building between providers, clients, and peers; and the provision of ISS and breastfeeding supportive material resources with educational opportunities. These findings may be used to inform community-level provider approaches to ISS and breastfeeding promotion.

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